Over half of all cancer patients will experience some form of sleep disturbance.1 Stress, anxiety and depression may also contribute to sleep problems. In turn, sleep problems may exacerbate psychological distress and add to fatigue. Cancer treatments may alter the usual patterns of sleep. For example, those undergoing cancer treatment may require naps in the day. Cancer-related fatigue may not respond to rest the way normal fatigue does, with the result that cancer survivors may always feel low energy and easily become tired.2 Knowing your patient’s sleep patterns and needs for rest will help you develop a better return to work plan. To help your patient track their sleeping patterns, you may want to refer them to the Pittsburgh Sleep Quality Index self-assessment tool.3
Sleep difficulties may add to fatigue. Some patients may have difficulty waking in the morning and thus may need to start work later. Taking sleep medications can make some people feel “foggy” in the morning. Poor sleep can affect concentration, memory, energy and emotions making the demands of work more challenging.
What patients can do
Sleep hygiene techniques are simple things patients can do to improve their sleep without using sleep medications. Advise patients to consult their physicians if problems with sleeping become chronic or impact their function or wellbeing.
The following resources can help patients manage sleep problems:
- Managing Sleep Problems after Cancer (PDF) – University Health Network
- Insomnia – Breastcancer.org
- Sleep problems – OncoLink
- Sleep disorders – Cancer.gov
- Prevention, Screening, Assessment and Treatment of Sleep Disturbances in Adults with Cancer (PDF) – Canadian Association of Psychosocial Oncology
- Sleep Disorders – University Health Network
- A free resource for relaxation strategies for sleep including a body scan for sleep – UCLA
- Twelve simple tips to improve your sleep – Division of Sleep Medicine, Harvard Medical School
Modify work schedules:
- Use flexible work hours to accommodate low-energy times of day.
- Change shifts to fit the patient’s highest daily energy levels.
Modify work environments:
- Set up a resting room, bring in a couch, or store a cot for employees to nap or rest during breaks or lunch.
Workplace changes and strategies to handle fatigue will also help with sleep disturbances.